Identifying health facilities outside the enterprise: challenges and strategies for supporting health reform and meaningful use

Abstract

Objective: To support collation of data for disability determination, we sought to accurately identify facilities where care was delivered across multiple, independent hospitals and clinics.Methods: Data from various institutions' electronic health records were merged and delivered as continuity of care documents to the United States Social Security Administration (SSA).Results: Electronic records for nearly 8,000 disability claimants were exchanged with SSA. Due to the lack of standard nomenclature for identifying the facilities in which patients received the care documented in the electronic records, SSA could not match the information received with information provided by disability claimants. Facility identifiers were generated arbitrarily by health care systems and therefore could not be mapped to existing international standards.Discussion: We propose strategies for improving facility identification in electronic health records to support improved tracking of a patient's care between providers to better serve clinical care delivery, disability determination, health reform, and meaningful use.Conclusion: Accurately identifying the facilities where health care is delivered to patients is important to a number of major health reform and improvement efforts underway in many nations. A standardized nomenclature for identifying health care facilities is needed to improve tracking of care and linking of electronic health records.

Consolidating CCDs from multiple data sources: a modular approach

“…In recent years, IHIE observed that multiple HIE partners, including other HIE networks in Indiana, members of the eHealth Exchange national HIE, and private enterprise health systems within its own network, began implementing CCD interfaces to send and receive information about individual encounters as well as a patient's past medical history (15,16). A total of 58 facilities within the IHIE network regularly send CCDs within the exchange.…”

Learning from the crowd while mapping to LOINC

“…Electronic data sharing across institutions is hampered by the heterogeneous names and formats used to store clinical data. 7,8 Only by adopting syntactic and semantic data standards can EHRs become interoperable and capable of integrating vast stores of variously formatted clinical data. Aiming to make clinical data available when and where it is needed, the certification criteria for EHRs under HITECH requires the use of common messaging and vocabulary standards.…”